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俄罗斯摩尔曼斯克州围产期死亡率的危险因素:一项基于登记处的研究。

Risk factors for perinatal mortality in Murmansk County, Russia: a registry-based study.

作者信息

Usynina Anna A, Grjibovski Andrej M, Krettek Alexandra, Odland Jon Øyvind, Kudryavtsev Alexander V, Anda Erik Eik

机构信息

a Department of Community Medicine, Faculty of Health Sciences , UiT The Arctic University of Norway , Tromsø , Norway.

b International School of Public Health , Northern State Medical University , Arkhangelsk , Russia.

出版信息

Glob Health Action. 2017;10(1):1270536. doi: 10.1080/16549716.2017.1270536.

Abstract

BACKGROUND

Factors contributing to perinatal mortality (PM) in Northwest Russia remain unclear. This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry.

OBJECTIVE

This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry.

METHODS

The study population consisted of all live- and stillbirths registered in the Murmansk County Birth Registry during 2006-2011 (n = 52,806). We excluded multiple births, births prior to 22 and after 45 completed weeks of gestation, infants with congenital malformations, and births with missing information regarding gestational age (a total of n = 3,666) and/or the studied characteristics (n = 2,356). Possible associations between maternal socio-demographic and lifestyle characteristics, maternal pre-pregnancy characteristics, pregnancy characteristics, and PM were studied by multivariable logistic regression. Crude and adjusted odds ratios with 95% confidence intervals were calculated.

RESULTS

Of the 49,140 births eligible for prevalence analysis, 338 were identified as perinatal deaths (6.9 per 1,000 births). After adjustment for other factors, maternal low education level, prior preterm delivery, spontaneous or induced abortions, antepartum hemorrhage, antenatally detected or suspected fetal growth retardation, and alcohol abuse during pregnancy all significantly increased the risk of PM. We observed a higher risk of PM in unmarried women, as well as overweight or obese mothers. Maternal underweight reduced the risk of PM.

CONCLUSIONS

Our results suggest that both social and medical factors are important correlates of perinatal mortality in Northwest Russia.

摘要

背景

俄罗斯西北部围产期死亡率(PM)的影响因素仍不明确。本研究基于摩尔曼斯克郡人群出生登记处的数据,调查了选定的孕产妇和胎儿特征与围产期死亡率之间的可能关联。

目的

本研究基于摩尔曼斯克郡人群出生登记处的数据,调查了选定的孕产妇和胎儿特征与围产期死亡率之间的可能关联。

方法

研究人群包括2006年至2011年在摩尔曼斯克郡出生登记处登记的所有活产和死产(n = 52,806)。我们排除了多胞胎、妊娠22周前和45周后出生的婴儿、患有先天性畸形的婴儿以及妊娠年龄(共n = 3,666)和/或所研究特征(n = 2,356)信息缺失的出生情况。通过多变量逻辑回归研究孕产妇社会人口学和生活方式特征、孕前特征、妊娠特征与围产期死亡率之间的可能关联。计算了粗比值比和调整后的比值比以及95%置信区间。

结果

在49,140例符合患病率分析条件的出生中,338例被确定为围产期死亡(每1000例出生中有6.9例)。在对其他因素进行调整后,母亲教育水平低、既往早产、自然流产或人工流产、产前出血、产前检测到或怀疑胎儿生长受限以及孕期酗酒均显著增加了围产期死亡的风险。我们观察到未婚女性以及超重或肥胖母亲的围产期死亡风险更高。母亲体重过轻降低了围产期死亡的风险。

结论

我们的结果表明,社会因素和医学因素都是俄罗斯西北部围产期死亡率的重要相关因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb3/5328313/d5b1d12d9989/zgha_a_1270536_f0001_b.jpg

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